Leo R Blais, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PCT.0014719 Issued in CT

Practice address

1137 Main St
East Hartford, CT 06108-2236

Phone

(602) 169-0778

Fax

(860) 310-3294

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connecticut CVS Pharmacy LLC

  • Pharmacy
  • Guilford, CT
  • NPI 1417746108
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1306405402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BANK ST",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166162",
            "telephone_number": "401-639-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082236",
            "telephone_number": "602-169-0778",
            "fax_number": "860-310-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIS",
        "first_name": "LEO",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH02605",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0014719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Bifolck
• Tanya R Bilchik, MD
• Bio-Medical Applications of Connecticut, Inc.
• Black & Mental Heatlh, LLC
• Josephine M Bladykas
• David B. Blonder, M.D.
• Christopher M Bloomfield
• Anne Boehmcke, BCBA, BHP
• Briana Lynn Bogrette
• Elizabeth Boig

• All providers in East Hartford, CT
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.